I had the distinct opportunity to attend the Collaborative Improvement and Innovation (COIN) meeting for the Safe Sleep initiative in Alabama this week and met some motivated leaders in the field who are passionate about making a difference in the arena of protecting infant life. This initiative will be collaborating with the Safe to Sleep campaign through the National Institute of Health. Encompassing 13 states, the five areas of focus for COIN are 1) Safe Sleep 2) Perinatal Regionalization 3) Smoking Cessation 4) Interconception Care and 5) Elective Deliveries before 39 weeks. All five focus areas have a single goal: lowering the infant mortality rate- saving babies' lives.
During the meeting, a common theme resounded. The second leading cause of death in children under the age of 18 years old is sleep related deaths. The first leading cause is attributed to vehicle accidents. Astonished? I am, too! What that means is in the state of Alabama the second leading killer of children is PREVENTABLE! In order to break this down, I feel it is first essential to explain and over explain what SIDS is not so that people realize they can prevent infant death....they can save babies' lives.
SIDS is the unexplained death of an infant under one year old diagnosed after autopsy, death scene investigation and child/family medical history review. If the cause of death remains unclear or unknown it is labeled SIDS. I bring this up again because many people think of any infant death as SIDS and that there was "nothing that could prevent it". If it is a true SIDS case and all of the requirements are met, then yes, you can't prevent it when you don't know happened. The actual SIDS rate is very low. However, if the death was preventable, IT IS NOT SIDS!
What is preventable? Sleep related deaths. And because they are preventable, they are NOT SIDS. A sleep related death is when a baby suffocates laying in an adult bed. A sleep related death is when a baby is trapped under another child and smothered during sleep. A sleep related death is when a baby is left to sleep in a car seat, his or her head falls forward and cuts off the airway causing the baby to stop breathing. A sleep related death is when a baby slips between the crib and the mattress because it is not properly fitted and becomes trapped. A sleep related death is when a baby is smothered by pillows, blankets and stuffed animals in the crib. It is gruesome, it is gory, but it is absolutely necessary for all of you to understand you can prevent sleep related deaths. And it is also essential to understand that we are not fighting SIDS here, we are fighting accidental deaths.
I firmly believe people have it in their minds that sudden infant death has us all clutched in its grasp with no recourse. It is simply not true. We must, MUST understand the distinction between SIDS and a sleep related death if we are ever going to move forward in lowering the infant mortality rate. What you know can save your baby's life.
It is a grave injustice for parents to be given a SIDS diagnosis for the death of their infant when in fact it was a sleep related death. This only puts future children at risk for an accident of the same kind. Being told "there was nothing you could have done, it was SIDS" when it was actually an accidental suffocation, entrapment or parent overlay will do nothing to help those parents. We have a responsibility as a medical community to be honest and upfront so parents can not only protect their own children, but also become advocates for other parents as well in safe sleep practices for infants.
Safe sleep means:
1) An infant should have their own sleeping environment with a firm sleep surface (crib, play yard) where they sleep alone
2) Nothing soft or plush should be put in the baby's sleeping area like heavy, thick blankets, pillows or stuffed animals
3) A baby should not sleep in an adult bed, on the couch or in a recliner due to the risk of suffocation
4) A baby should not sleep in a car seat, swing or bouncer due to the risk of closing off the airway
Be safe out there and know that you can protect your baby's life!
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